The purpose of this study was to examine the effect of a six-month lifestyle-based intervention on health-related quality of life (HRQOL) in older adults with hypertension. A secondary analysis of a randomized controlled trial was conducted to test the differences between the intervention and control groups on HRQOL (N=196). The results indicated that there were no statistically significant differences between the intervention and control groups on change in HRQOL, but the final regression models were statistically significant. SF-36 mental component summary (MCS) score at baseline, stress at baseline, and change in stress were significant predictors for predicting change in the SF-36 MCS. SF-36 physical component summary (PCS) at baseline and change in stress were significant predictors for predicting change in the SF-36 PCS. The findings suggest that the development of an effective intervention in improving HRQOL should be considered within individual, interpersonal, societal, and cultural factors for future research and clinical practice.